Central odontogenic fibroma

Abstract

Central odontogenic fibroma (COF), which has been categorized under the subheading of odontogenic tumors of ectomesenchyme, is such an uncommon neoplasm that much of its nature is left uncharted. COF is a rare tumor that accounts for 0.1% of all odontogenic tumors. Clinically, the lesion grows slowly and leads to cortical expansion. Radiologically, the lesion may be unilocular or multilocular. In some cases, it may be associated with root resorption or displacement. Histopathologically, the lesion is characterized by mature collagen fibers and numerous fibroblasts. A case of COF of the mandible in a male patient aged 49 years is described in this report. The patient showed no symptoms, no history of swelling discomfort or pain, and was unaware of the presence of the lesion. Orthopantomogram (OPG) showed generalized bone loss along with a unilocular radiolucent area, with a clear sclerotic lining and angular bone loss. Surgical enucleation of the lesion along with placement of osseo-graft, which is a bioresorbable demineralized bone matrix (DMBM), and platelet-rich fibrin was carried out in the defect site. Following surgery, patient was recalled for revaluation of the lesion; the surgical site showed good healing and an increase in bone height was seen.

Central odontogenic fibroma (simple type) in a four-year-old boy: atypical cone-beam computed tomographic appearance with periosteal reaction

“…COF is classified as a rare benign tumor that originates from ectomesenchymal tissues such as the dental papillae, periodontal ligament, or dental follicle. 3 12 13 It is most often found in females, and the ratio of incidence in the maxilla and mandible is approximately 1 : 1, with a slight tendency to favor the mandible. It involves the anterior part of the maxilla, whereas mandibular lesions affect the premolar and molar areas.…”

Central Odontogenic Fibroma: characteristics and management

“…These clinical signs might also be functional with pain in 6.7% of cases [7,12,32,[36][37][38][39][40]. COF might also be discovered incidentally on standard radiograph in 23% of cases [33,[36][37][38][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56].…”

“…The treatment of choice for COF was surgical enucleation, which was performed in 2/3 of cases (65.9% of cases) [6,8,10,11,[16][17][18][21][22][23][24][26][27][28][29][30]32,[36][37][38][40][41][42]45,46,49,51,[54][55][56][58][59][60]62,64,[66][67][68][73][74][75][76]78,79,[81][82][83] (Fig. 4).…”

“…The mean duration of patient follow-up after COF treatment was 35 months (SD 39.1, range 1 month to 180 months) for the 86 cases reporting this duration [6,7,[9][10][11][12][13][14][16][17][18][19][20]22,24,[27][28][29][30][32][33][34]36,38,[42][43][44][46][47][48][49][50][51][52][53][54][55][56][57][58][59]62,65,66,[68][69][70][71][72][73][74]…”

“…The recurrence rate of COF was 6% and its annual recurrence rate was 1.4%. For these calculations, only data from 67 patients with a minimum follow-up of 12-months after surgical treatment was considered (estimated duration of effective mucosal and bone healing) [6,7,9,10,12,14,[16][17][18][19]22,[27][28][29][32][33][34]36,38,[42][43][44]46,[48][49][50][51][52][55][56][57][58][59]62,65,66,69,70,72,73,78,81,83,85]. This recurrence rate of 6% was lower than the rate of 10% suggested by Correa Pontes et al [2].…”